89 research outputs found
Studies on Leaf Analysis 1. Seasonal variation of carbohydrates in rice plants
葉分析は作物栄養診断上極めて適確なることは, 曩の予備的実験に於て認めた処であるが, 本報文は各肥料条件下に栽培する水稲を供試し, 葉分析により生育中に於ける体内炭水化物の状態を明かにせんとしたものであるその結果得たるもの次の如し。(1)水稲葉中には生育期を通じ, 可溶糖として蔗糖過半を占め, 還元糖少し。(2)葉身及葉鞘共生育進むに従い, 蔗糖含量を増し成熟期に低下す。(3)葉身中蔗糖は開花期に一時的に低下す。此は開花に蔗糖が多量需要されることを暗示する。(4)澱粉は全生育期中葉身には殆んど存在せざるも, 葉鞘には多量蓄積される時期-幼穂形成期-あり。之は水稲の注目すべき生理機能なり。(5)加里缺除及窒素過用の肥料条件は葉鞘中の蓄積澱粉を減少せしめる。即ち之等条件は光合成機能を阻害せしめるのであろう。(6)適当なる生育時期に於ける葉鞘中澱粉含量は水稲体の栄養状態を表示するから, 稲作診断上に一指標を与えるであろう。 / Carbohydrates, that is, sucrose, reducing sugar, and starch in leaf blade, leaf sheath, and top internode of rice plants were determined by photoelectric colorimeter by field experiment grown on varied fertilizer treatments. In complete plot, as normal growth was observed, sucrose content in dry leaf blade ranged from about 1 to 5%, gradually increasing as growth proceeds. At flowering stage, temporary decrease was observed, but in leaf sheath it was no evidence. We assume that at flowering stage ear demands much carbohydrates, so that sucrose are transported from leaf blade to ear. Reducing sugar content in leaf blade and leaf sheath ranged from 0.1∿1%. It is appeared that in leaf sheath maximum value was observed tillering and flowering stage. Starch was scarecely observed in leaf blade, but in leaf sheath contained remarkably, for example in complete plot 15%, at the stage between vegetative and reproductive phase-probably in the ear bud formation stage. This is a notable physiological function of rice plants. On the difference by varied fertilizer treatments, especially in respect to starch content in leaf sheath, NP or N plots reduced starch content, but K plot increased. We consider that K element indicates the rate photosynthesis. For the nutritional diagnosis of rice plants, we propose that starch content in leaf sheath at suitable stage is important index
It’s not just the Therapist: Therapist and Country-Wide Experience Predict Therapist Adherence and Adolescent Outcome
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173905.pdf (publisher's version ) (Open Access)Objective: Therapist adherence is a quality indicator in routine clinical care when evaluating the success of the implementation of an intervention. The current study investigated whether therapist adherence mediates the association between therapist, team, and country-wide experience (i.e. number of years since implementation in the country) on the one hand, and treatment outcome on the other hand. We replicated and extended a study by Löfholm et al. (2014). Method: Data over a 10-year period were obtained from 4290 adolescents (12-17 years) with antisocial or delinquent problem behavior, who were treated with Multisystemic Therapy (MST) by 222 therapists, working in 27 different teams in the Netherlands. Multilevel structural equation modeling was used to assess the associations between experience, therapist adherence, and post-treatment outcomes. Results: Treatment outcomes were directly predicted by therapist experience, countrywide experience, and therapist adherence, but not by team experience. Moreover, therapist adherence mediated the association between therapist and country-wide experience, and treatment outcomes. The association between therapist experience and therapist adherence was not affected by the number of years of team experience or country-wide experience. Conclusion: The effect of country-wide experience on outcome may reflect increasing experience of training and supporting the therapists. It suggests that nation-wide quality control may relate to better therapist adherence and treatment outcome for adolescents treated with systemic therapy.17 p
Unmet care needs of patients with advanced cancer and their relatives:multicentre observational study
Objectives: The care needs of patients with advanced cancer and their relatives change throughout the disease trajectory. This study focused on the care-related problems and needs of patients with advanced cancer and their relatives. This was done from the perspective of centres for information and support. Methods: This cross-sectional study used data from the eQuiPe study: an observational cohort study in which 40 Dutch hospitals participated. All adult patients with a diagnosis of a metastasised tumour and their relatives were eligible. Measures included information on the patients' and relatives' care problems and needs, assessed by the short version of the Problems and Needs in Palliative Care questionnaire. Socioeconomic demographics were also collected. Results: 1103 patients with advanced cancer and 831 relatives were included. Both patients (M=60.3, SD=29.0) and relatives (M=59.2, SD=26.6) experienced most problems in the domain of â € psychological issues'. Both patients (M=14.0, SD=24.2) and relatives (M=17.7, SD=25.7) most frequently reported unmet needs within this domain. The most often reported unmet need by patients was â € worrying about the future of my loved ones' (22.0%); for relatives this was â € fear for physical suffering of the patient' (32.8%). There was no clear relationship between socioeconomic demographics and the experienced unmet needs. Conclusions: The most often mentioned unmet needs consisted of fears and worries, followed by a broad range of topics within multiple domains. Centres for information and support may play a role in reducing the unmet needs of (potential) visitors as these centres provide support on a broad range of topics.</p
Starting a Crossover Kidney Transplantation Program in The Netherlands: Ethical and Psychological Considerations
On April 15th, 2003, the first crossover kidney transplantation took place in The Netherlands. In September of the same year, a national database was established to facilitate kidney exchange between two donor-recipient couples. During 2004, kidneys from living donors will be exchanged between the seven university medical centers in The Netherlands. One of the conditions for successfully implementing this program was the need to address the ethical and psychologic implications involved. In this article we will discuss the ethical and psychologic considerations that are accompanying the practical preparations for the first Dutch crossover transplantation program. We identified five topics of interest: the influence of "donation by strangers" on the motivation and willingness of donor-patient couples, the issue of anonymity, the loss of the possibility of "medical excuses" for unwilling donors, the view that crossover is a first step to commercial organ trade, and the interference with existing organ donation programs. We concluded that whether viewed separately or in combination, these issues do not impede the efficient organization of a crossover program or raise worrying ethical issues. Key Words: Ethics, psychology, crossover transplantation, kidney exchange program. 2004;78: 194 -197) T he Netherlands has a population of 16 million. Approximately 375 to 425 kidneys per year are transplanted from cadaver donors. In addition to cadaver transplants, approximately 200 kidneys from living donors were transplanted during 2003. Although the growing number of available living donors helps prevent the waiting lists from growing further, there are not enough kidneys available to help the 1,300 patients already on the waiting list. After starting dialysis, kidney patients have an average waiting time of 4 years before a kidney becomes available. In the meantime, their health status declines. Currently, the mortality rate of patients on dialysis is approximately 20% per year (1). (Transplantation Living organ donation by family or friends offers an opportunity to reduce the long waiting lists. However, in a third of these cases, the transplantation cannot take place because of ABO incompatibility or donor-specific sensitization (2). A crossover transplantation program offers new hope. The program provides a lifesaving opportunity when a donor cannot give his or her kidney to his or her recipient. If another donor-recipient couple experiences the same problem, the kidneys can be exchanged. In South Korea, such a crossover kidney exchange program has been operating successfully for more than 10 years (3). The United States also has experience with "kidney swapping" (4). In Europe, however, crossover transplantations have been attempted only once in Switzerland, in Romania, and in Rotterdam. This conservative European attitude is in part explained by concerns surrounding the ethical and psychologic implications of crossover transplantation. When a crossover program was initiated in The Netherlands, it was agreed that these concerns should be addressed. A multidisciplinary research effort was conducted to determine the most prominent psychologic and ethical issues that surround crossover kidney exchange and to propose practical solutions. We identified five topics of interest: (1) the influence of "donation by strangers" on the motivation and willingness of donor-patient couples; (2) the issue of anonymity; (3) the loss of the possibility of "medical excuses" for unwilling donors; (4) the view that crossover might be the first step to commercial organ trade; and (5) the interference with existing organ donation programs. Next we describe these five topics in detail and suggest practical solutions. Living Organ Donation by Strangers When discussing the ethical and psychologic issues of a crossover transplantation program, a prominent issue is the possibility of a difference in motivation and willingness of kidney donors and recipients compared with the attitudes of those involved in a direct living donation program. At first glance, crossover donation between two couples is not significantly different from direct living kidney donation. The motivation of the donor is the same: helping a friend or a family member by giving a kidney. The result for the patient is equivalent as well: He or she receives the much needed organ. Furthermore, the medical impact for the four people involved is the same as for the two direct living kidney donors. Psychologically, however, it might matter for those involved whethe
Should health care professionals encourage living kidney donation?
Living kidney donation provides a promising opportunity in situations where the scarcity of cadaveric kidneys is widely acknowledged. While many patients and their relatives are willing to accept its benefits, others are concerned about living kidney programs; they appear to feel pressured into accepting living kidney transplantations as the only proper option for them. As we studied the attitudes and views of patients and their relatives, we considered just how actively health care professionals should encourage living donation. We argue that active interference in peoples’ personal lives is justified - if not obligatory. First, we address the ambiguous ideals of non-directivity and value neutrality in counselling. We describe the main pitfalls implied in these concepts, and conclude that these concepts cannot account for the complex reality of living donation and transplantation. We depict what is required instead as truthful information and context-relative counselling. We then consider professional interference into personal belief systems. We argue that individual convictions are not necessarily strong, stable, or deep. They may be flawed in many ways. In order to justify interference in peoples’ personal lives, it is crucial to understand the structure of these convictions. Evidence suggests that both patients and their relatives have attitudes towards living kidney donation that are often open to change and, accordingly, can be influenced. We show how ethical theories can account for this reality and can help us to discern between justified and unjustified interference. We refer to Stephen Toulmin’s model of the structure of logical argument, the Rawlsian model of reflective equilibrium, and Thomas Nagel’s representation of the particularistic position
Avoiding or Reversing Hartmann’s Procedure Provides Improved Quality of Life After Perforated Diverticulitis
# 2010 The Author(s). This article is published with open access at Springerlink.com Introduction The existing literature regarding acute perforated diverticulitis only reports about short-term outcome; longterm following outcomes have not been assessed before. The aim of this study was to assess long-term quality of life (QOL) after emergency surgery for perforated diverticulitis. Patients and Methods Validated QOL questionnaires (EQ-VAS, EQ-5D index, QLQ-C30, and QLQ-CR38) were sent to all eligible patients who had undergone emergency surgery for perforated diverticulitis in five teaching hospitals between 199
J.J.: Validity and feasibility of the use of condition-specific outcome measures in economic evaluation
Abstract Background: Usually, generic questionnaires such as the EQ-5D or Health Utility Index (HUI) are used to obtain utility scores for computing QALYs. Sometimes, however, application of these instruments is not possible, or the responsiveness is doubted. An alternative strategy is to attribute utility scores to health states of a condition-specific outcomes measure (CSOM). We explored the validity and feasibility of this strategy. Research design: Our samples determined utility scores for the health states of the International Index of Erectile Function (IIEF) using time tradeoff (TTO). To reduce costs and time, the general population (n ¼ 169) was interviewed in groups. We tested the validity of the group sessions in students. To test the extent of agreement between values obtained using the group and those obtained through individual administration, 63 students were interviewed individually and 54 in groups. Results: The utility scores for the disease-specific health states showed good construct validity. Also, the criterion validity of the adapted TTO was confirmed. Discussion: Disease-specific utility scores can be used in QALY analysis by converting them to a generic scale. Efforts should be undertaken to prevent response spreading. Administrating TTO in groups could reduce the time and costs of TTO administration and render the strategy of determining utilities for condition-specific health states more feasible
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